Medicare reimbursement L-codes by state.

View a complete listing of the 22 L-codes introduced by CMS in 2006 & 2007.
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HCPCS Code Update
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Terminology

• Orthotics: The science of fabricating and fitting orthoses
• Orthosis: Used to describe a single device. A rigid or semi-rigid device that supports a weak or deformed body member, or restricts or eliminates motion in a diseased or injured part of the body. An orthosis can be custom fabricated, custom fit or prefabricated.
• Orthoses: Used to describe multiple devices
• Prefabricated: Off-The-shelf: Orthoses which requires minimal self adjustment for appropriate use and do not require expertise in trimming, bending, molding, assembling, or customizing to fit the beneficiary.
• Custom Fitted: A prefabricated device, which is manufactured in quantity without a specific patient in mind. The device may or may not be supplied as a kit that requires some assembly and/or fitting and adjustment, or a device that must be trimmed, bent, molded (with or without heat), or otherwise modified by an individual with expertise in customizing the item to be fit and used by a specific patient.
• Custom Fabricated: A custom fabricated item is one that is individually made for a specific patient. No other patient would be able to use this item. A custom fabricated item is a device which is fabricated based on clinically derived and rectified castings, tracings, measurements, and/or other images (such as x-rays) of the body part. The fabrication may involve using calculations, templates and components. This process requires the use of basic materials including, but not limited to plastic, metal, leather or cloth in the form of uncut or unshaped sheets, bars, or other basic forms and involves substantial work such as vacuum forming, cutting, bending, molding, sewing, drilling and finishing prior to fitting on the patient.
• Splint: refers to casts and strapping used for reductions of fractures and dislocations. Splinting is a term that should not be used by therapists that are fabricating or issuing an orthoses. It is used by physician offices for applying a cast. There are CPT codes for splinting that are used when billing for this.
• Without joints: This is a static orthosis. This indicates that the orthosis has no dynamic/static progressive component acting on any joint included in the orthosis
• Elastic bands and Turnbuckles: If these terms are in the description then this indicates at least one joint but could be multiple joints has a dynamic or static progressive component(s) acting upon it. The intent is to mobilize an anatomical area.

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